JP6591528B2 - Variable outpost spacer and related usage - Google Patents

Description

Cross-reference of related applications

  This application is a continuation-in-part of US application Ser. No. 14 / 175,601, filed Feb. 7, 2014, the contents of which are hereby incorporated by reference in their entirety for all purposes. .

  Various embodiments of the present disclosure are generally directed to variable forehead spacers and related systems and methods. More specifically, the present disclosure relates to devices, systems, and methods for correcting sentiment and / or other spinal abnormalities.

  A common procedure for addressing pain associated with deformed discs due to various factors such as trauma or aging is the use of an intervertebral fixation device to fix one or more adjacent vertebral bodies. is there. Generally, in order to fix adjacent vertebral bodies, the intervertebral disc is first partially or completely removed. The intervertebral fixation device is then typically inserted between adjacent vertebrae to promote intervertebral fixation by maintaining normal intervertebral disc spacing and restoring spinal stability.

  There are many known conventional fixation devices and methodologies in the art to achieve intervertebral fixation. These include fixation devices including screw and rod arrangements, solid bone implants, and cages or other implantation mechanisms that are typically filled with bone and / or bone growth inducers. These devices are implanted between adjacent vertebral bodies to secure the vertebral bodies together to reduce associated pain.

  However, there are disadvantages associated with known conventional fixation devices and methodologies. For example, current methods for installing conventional fixation devices often pull adjacent vertebral bodies away from the affected disc space to its normal or healthy height prior to implantation of the fixation device. Need to recover. In order to maintain this height once the anchoring device has been inserted, the anchoring device is usually a dimension that is greater than the initial pull-off height. This height difference can make it difficult for the surgeon to place the fixation device in the separated disc space.

  Furthermore, the lordosis refers to the curvature of the spine, particularly the curvature that is recessed backwards. In certain patients, this curvature may be greater than desired, for example. Traditional vertebral fixation procedures and devices do not accurately account for this curvature. Thus, traditional devices do not properly align with adjacent vertebral bodies. Bone may be removed from the vertebral body to ensure an accurate fit of traditional devices, but increases treatment and healing time.

  Thus, there is a need for a fixation device that can be placed in an intervertebral disc space with minimal separation height, and a fixation device that can maintain a normal distance between adjacent vertebral bodies when implanted. Exists.

  The present disclosure relates to expandable fixation device embodiments and related methods of use.

  In one aspect, the present disclosure is directed to an expandable fixation device that can include a first end plate and a second end plate. The expandable fixation device may also include a first ramp configured to mate with both the first and second end plates. The first ramp may be a wedge having an inclined surface extending along the longitudinal axis of the expandable fixation device, or may be a wedge having an inclined surface extending along the transverse axis of the expandable fixation device. Good. The second lamp may be configured to mate with both the first and second end plates. The second ramp may be a wedge having an inclined surface extending along the longitudinal axis of the expandable fixation device, or a wedge having an inclined surface extending along the transverse axis of the expandable fixation device. Good.

  Various embodiments of the present disclosure can include one or more of the following aspects. The first and second end plates each have at least one first fit configured to mate with at least one corresponding first mate feature disposed on the first ramp. A combined feature may be included. At least one mating feature of the first and second end plates may be slidable relative to a corresponding first mating feature disposed on the first ramp. The first and second end plates each include a second mating feature configured to mate with a corresponding second mating feature disposed on the first lamp. Can do. Each of the second fitting feature and the corresponding second fitting feature may be C-shaped, V-shaped, or U-shaped. The first and second end plates each include a third mating feature configured to mate with a corresponding third mating feature disposed on the second lamp. Can do. Each of the third fitting feature and the corresponding third fitting feature may be C-shaped, V-shaped, or U-shaped. Each of the first and second end plates can have an inner surface configured to mate with the first lamp. The inner surface of each of the first and second end plates may be shaped as a concave curved surface that is formed about the longitudinal axis of the expandable fixation device. The expandable fixation device may be movable between a collapsed configuration and an expanded configuration. The first ramp may be coupled to the second ramp by an actuation mechanism, and the expandable fixation device is configured to transition from a folded configuration to an expanded configuration by actuation of the actuation mechanism, the second ramp and The first lamps can be moved towards each other. In the expanded configuration, the expandable fixation device may be a wedge having an inclined surface extending along the transverse axis of the expandable fixation device. Each of the first and second end plates can have an outer surface configured to contact a respective vertebral body. Each outer surface of the first and second end plates may have one or more of teeth, ridges, friction increasing elements, keels, or gripping or purchasing protrusions.

  In another aspect, the present disclosure may be directed to an expandable fixation device. The expandable fixation device can include a first end plate and a second end plate, both of the first and second end plates being from the first side of the expandable fixation device. Can extend to the second side. The expandable fixation device can also include a first lamp and a second lamp. The first lamp and the second lamp may be configured to mate with both the first and second end plates, and both the first lamp and the second lamp are expandable fixation devices. Extending from the first side of the first to the second side of the expandable fixation device. At least one of the first and second sides of the expandable fixation device can be pivotally expanded about the inversion.

  Various embodiments of the present disclosure can include one or more of the following aspects. Both the first and second sides of the expandable fixation device can be pivotally expanded about the same inversion. The same center of rotation may be a point disposed outside the expandable fixation device. The inversion may be disposed along the first side of the expandable fixation device or between the first side and the second side. Only the second side of the expandable fixation device can pivot about the inversion.

  In yet another aspect, the present disclosure may be directed to an expandable fixation device. The expandable fixation device can include a first end plate and a second end plate, both of the first and second end plates being from the first side of the expandable fixation device. Can extend to the second side. The expandable fixation device can also include a first lamp and a second lamp, such that both the first lamp and the second lamp mate with both the first and second end plates. Both the first lamp and the second lamp can extend from the first side of the expandable fixation device to the second side of the expandable fixation device. The first and second sides of the expandable fixation device can form concentric arcs about the centroid.

  Various embodiments of the present disclosure can include one or more of the following aspects. The expandable fixation device may be movable between a collapsed configuration and an expanded configuration, and both the first and second sides of the expandable fixation device move between the collapsed configuration and the expanded configuration. Sometimes it has the same rate of angular change. The first side of the expandable fixation device may be defined by a first radius, the second side of the expandable fixation device may be defined by a second radius, and the first radius is It may be smaller than the second radius.

  In yet another aspect, the present disclosure may be directed to an expandable fixation device having a first end plate and a second end plate. The first and second end plates can each include at least one mating feature. The first ramp may be configured to mate with both the first and second end plates, the first ramp having a first angle with respect to the vertical axis. Can be included. The mating feature of the first end plate and / or the second end plate is slidable relative to a corresponding first mating feature disposed on the first ramp. The second ramp may be configured to mate with both the first and second end plates, the second ramp having a second angle with respect to the vertical axis. Can be included. The first angle may be the same as or different from the second angle. If different, the first angle may be larger or smaller than the second angle. It may be preferred that the second angle is smaller than the first angle.

  Various embodiments of the present disclosure can include one or more of the following aspects. The first angle is larger than the second angle. The first angle is about 50-70 °. The first angle is about 60 °. The second angle is about 5-25 degrees. The second angle is about 15 °. The first and second lamps are configured to provide a symmetrical extension of the first and second end plates. At least a portion of the first lamp includes a curved lamp surface. At least a portion of the first ramp has a ramp angle that varies continuously.

  The accompanying drawings, which are incorporated in and constitute a part of this specification, illustrate various exemplary embodiments and, together with the description, serve to explain the principles of the disclosed embodiments.

FIG. 4 is a side view of an embodiment of an expandable fixation device shown between adjacent lordosis vertebrae according to the present disclosure. 1 is a longitudinal side view of an expandable fixation device in a first configuration according to the present disclosure. FIG. FIG. 3 is a side view of the expandable fixation device of FIG. 2. FIG. 4 is a cross-sectional view of the expandable fixation device of FIG. 2 taken along line 4-4. Figure 3 shows the expandable fixation device of Figure 2 in a second configuration. FIG. 6 is a side view of the expandable fixation device of FIG. FIG. 7 is a cross-sectional view of the expandable fixation device of FIG. 5 taken along line 7-7. FIG. 3 is a side view of the expandable fixation device of FIG. 2 in a first configuration, showing the inversion. FIG. 9 is a side view of the expandable fixation device of FIG. 2 in a second configuration, showing the inversion of FIG. FIG. 3 is a perspective view of the expandable fixation device of FIG. 2. FIG. 3 is an exploded view of the expandable fixation device of FIG. 2. FIG. 3 is another exploded view of the expandable fixation device of FIG. 2. FIG. 13 is a side view of an end plate incorporated in the expandable fixation device of FIG. 12. It is a top view of the end plate of FIG. FIG. 14 is a longitudinal side view of the end plate of FIG. 13. FIG. 13 is a perspective view of a first lamp incorporated in the expandable fixation device of FIG. 12. It is a side view of the 1st lamp | ramp of FIG. FIG. 13 is a side view of a second lamp incorporated in the expandable fixation device of FIG. 12. FIG. 6 is a cross-sectional view of an expandable fixation device according to another embodiment of the present disclosure. FIG. 4 is an exploded view of an expandable fixation device according to another embodiment of the present disclosure. FIG. 21 is a perspective view of the expandable fixation device shown in FIG. 20. FIG. 21 is a side view of the expandable fixation device shown in FIG. 20, showing different expansion rates between the front and back of the implant. FIG. 21 is a cross-sectional view of the expandable fixation device shown in FIG. 20 including a ramp angle. FIG. 21 is a side view of the expandable fixation device shown in FIG. 20, showing the ramp angle. FIG. 3 is a front view of a front first lamp that may be used with any of the expandable fixation devices described herein. FIG. 26 is a top view of the first lamp shown in FIG. 25.

  Reference will now be made in detail to the embodiments of the present disclosure, examples of which are illustrated in the accompanying drawings. Wherever possible, the same reference numbers will be used throughout the drawings to refer to the same or like parts.

  Spinal fixation is typically used to eliminate pain caused by the carrying of deformed disc material. When well fixed, the fixation device is permanently fixed within the disc space. Referring to FIG. 1, an expandable fixation device 10 is shown between adjacent vertebral bodies 2 and 3. The expandable fixation device 10 can extend from a first side 22 (eg, back side) to a second side 24 (eg, front side). The expandable fixation device 10 can engage the endplates of adjacent vertebral bodies 2 and 3 and maintain normal disc spacing and restore spinal stability in the installed position, thereby restoring vertebral stability. Promote inter-fixation. In some embodiments, the expandable fixation device 10 provides indirect decompression (eg, by reducing the pressure of the vertebral bodies 2 and 3 on adjacent nerves) while still providing lordosis correction. be able to. The expandable fixation device 10 may be formed from any suitable material or combination of materials, among others, titanium, stainless steel, titanium alloys, non-titanium metal alloys, polymeric materials, plastics, plastic composites, polyether ethers. Examples include, but are not limited to, ketones (PEEK), ceramics, and elastic materials.

  In embodiments, the expandable fixation device 10 can be configured and sized to be placed under the insertion tube and in the disc space between adjacent vertebral bodies 2 and 3. For example, the expandable fixation device 10 may be configured for insertion through an insertion tube, such as a cannula, for example. However, it should be noted that the insertion tube may alternatively have any suitable diameter. In one embodiment, the expandable fixation device 10 may be inserted through a cannula having a diameter of about 8.5 mm. In some embodiments, the expandable fixation device 10 may have a width in the range of about 8 mm to about 26 mm and a length in the range of about 20 mm to about 65 mm, or other suitable dimensions. You may have. The expandable fixation device 10 can be inserted into the patient via a direct outer procedure, although anterior, anterolateral, posterior or posterior treatment may alternatively be utilized.

  The expandable fixation device 10 may be generally wedge-shaped and may have a height that increases from the first side 22 toward the second side 24. In some embodiments, the expandable fixation device 10 can be expanded to a height equal to or greater than about 150% of its initial height. In one embodiment, the expandable fixation device 10 may be expanded to a height equal to its initial height, or greater than about 200%, or greater than another suitable percentage of its height.

  As shown in FIG. 10, the expandable fixation device 10 can include one or more openings 26 to accommodate bone growth along the longitudinal length of the expandable fixation device 10. In some embodiments, the openings 26 may have the same dimensions, or alternatively may have different dimensions. In the illustrated embodiment, the expandable fixation device 10 has two openings 26, although other suitable numbers and sizes of openings are contemplated. The opening 26 may be large enough to promote bone growth after placement of the expandable fixation device 10 between the vertebral bodies 2 and 3.

  In an exemplary embodiment, a bone graft or similar bone growth inducing material can be introduced around and within the expandable fixation device 10 to further facilitate and facilitate intervertebral fixation. In one embodiment, the expandable fixation device 10 is filled with a bone graft (eg, autograft or allograft) or similar bone growth-inducing material and passes through and around the expandable fixation device 10. It can promote bone growth. The bone graft may be filled between adjacent vertebral body endplates before, after, or during implantation of the fixation device.

  In one embodiment, the expandable fixation device 10 is treated with titanium and / or hydroxyapatite plasma spray coating to promote bone growth and between each component and the underlying bone (eg, vertebral body). Improve the strength and stability of the connection. Any other suitable coating may be provided on the expandable fixation device 10. Such a coating can include a therapeutic agent, if desired. The expandable fixation device 10 can also include radiopaque markings to facilitate in vivo visualization. In some embodiments, portions of the expandable fixation device 10 may be formed of a radiopaque material, while other portions of the expandable fixation device 10 are formed of a radiopaque material. For example, imaging of radiopaque portions of the expandable fixation device 10 such as an actuation mechanism, end plate, lamp, or the like can be facilitated.

  With reference to FIGS. 2-12, an embodiment of an expandable fixation device 10 is shown. In the exemplary embodiment, the expandable fixation device 10 can include a first end plate 14, a second end plate 16, a first ramp 18 and a second ramp 20. The expandable fixation device 10 may be movable between the folded configuration shown in FIGS. 2-4 and 8 and the expanded configuration shown in FIGS. The ability of the expandable fixation device 10 to move between a collapsed configuration and an expanded configuration can provide a number of advantages. For example, because the expandable fixation device 10 can be inserted between the vertebral bodies 2 and 3 in a collapsed configuration that is smaller than the expanded configuration, the large impact force required to install a traditional fixation device is dilated. Is not required to install the sex fixation device 10. In one embodiment, the expandable fixation device 10 can be in a folded configuration in a prone state, although other suitable configurations are also contemplated, such as, for example, parallel or other starting angles.

  The expandable fixation device 10 can be expanded and folded around the set inversion center P shown in FIGS. The expandable fixation device 10 may be configured to change the position of the centroid P. That is, the first ramp 18, the second ramp 20 and the end plates 14, 16 may be constructed to exhibit curvature about the center of rotation P (eg, curvature, as will be further described below). May have a radius). In the folded configuration shown in FIGS. 2-4 and 8, the expandable fixation device 10 can maintain an angle α relative to the inversion P (shown only in FIG. 8). In the expanded configuration shown in FIGS. 5-7 and 9, the expandable fixation device 10 can maintain an angle β relative to the inversion P (shown only in FIG. 9). The construction of the expandable fixation device 10 can also select the rate of change between the angles α and β in the transition of the expandable fixation device 10 between the folded configuration and the expanded configuration. In some embodiments, the expandable fixation device 10 may experience a linear increase in the lordosis angle during the transition from the folded configuration to the expanded configuration (ie, through the expansion range). In some embodiments, the expandable fixation device 10 may be configured to set the inversion P closer to the expandable fixation device 10 (or even within the outer periphery of the expandable fixation device 10). Good. The rate of angular change per height change exhibited by the expandable fixation device 10 as the inversion P moves toward the expandable fixation device 10 (or further toward the midline 204 shown in FIGS. 8 and 9). Can increase. Since the second side 24 has a greater distance from the center of rotation P than the first side 22, the second side 24 is the first in the transition of the expandable fixation device 10 from the folded configuration to the expanded configuration. The height can increase faster than side 22. Thus, the expandable fixation device 10 can be constructed in various configurations to set different α and β angles (ie, different ramp angles on the front and back sides of the expandable fixation device 10).

  The position of the inversion P may depend on the inclined surface of the expandable fixation device 10 between the first side 22 and the second side 24 or may be independent. That is, when the height difference between the first side 22 and the second side 24 increases, the inversion P is closer to the expandable fixation device 10 or even of the expandable fixation device 10. It can be set within the outer edge. Thus, when the center of rotation P is set closer to the expandable fixation device 10 (or even towards the midline 204), the angles α and β may be larger. Conversely, when the inversion P is set far from the expandable fixation device 10, the rate of angular change per height change is smaller and smaller α and β angles are present in the expandable fixation device 10. .

  In one embodiment, α may be about 10.4 °, β may be about 22.5 °, and the distance d between the inversion P and the first side 22 may be about 17 mm. However, other suitable values are also contemplated.

Thus, the first and second sides 22, 24 or the expandable fixation device 10 may be formed as a circular arc (eg, a concentric circular arc) about the centroid P. In the folded configuration, the first side 22 may be oriented at an angle α with respect to the centroid P and may have a radius r _pc . In the folded configuration, the second side 24 may also be oriented at an angle α relative to the centripet P because the second side 24 may be oriented at a distance from the centripet P more than the first side 22. _May have a radius r _ac that is greater than the radius r _pc . In the expanded configuration, the first and second sides 22, 24 of the expandable fixation device 10 can expand at a substantially similar angular velocity, even if both are oriented at an angle β with respect to the inversion P. Good. In the expanded configuration, the first side 22 may have a constant radius r _pe regardless of the radius r _pc .

  The curvature of the first ramp 18, the second ramp 20 and the end plates 14, 16 can determine the position of the inversion P. As shown in FIGS. 8 and 9, the curvature of the first ramp 18, the second ramp 20 and the end plates 14, 16 causes the first and second sides 22, 24 of the expandable fixation device 10 to roll. The portion of the concentric arc described above can be formed by curving around the center P. The curvature of the first and second sides 22, 24 can set the distance of the inversion P from the first and second sides 22, 24. That is, if the expandable fixation device 10 is constructed to position the center of rotation P relatively far from the first and second sides 22, 24, each of the first and second sides 22, 24 is Can have a shallower curvature. Conversely, the expandable fixation device 10 is constructed to position the inversion P relatively close to the first and second sides 22, 24 (or even between the first and second sides 22, 24). If so, each of the first and second sides 22, 24 can have a steeper curvature.

  With reference to FIGS. 11 and 12, the end plates 14, 16 can have a first end 30 and a second end 32. In the illustrated embodiment, the end plates 14, 16 connect the first end 30 and the second end 32 to the outer surface 40 connecting the first end 30 and the second end 32. And an inner surface 42. Both the outer surface 40 and the inner surface 42 may be defined by the first and second ends 30, 32 and by the first side 44 and the second side 45. The first side 44 of the end plates 14, 16 may be disposed on the first side 22 of the expandable fixation device 10. Similarly, the second side 45 of the end plates 14, 16 may be disposed on the second side 24 of the expandable fixation device 10. The first and second sides 44, 45 define a plurality of mating features configured to engage one or more mating features of the first ramp 18 and the second ramp 20. be able to. In one embodiment, both the first and second sides 44, 45 can extend from the inner surface 42. The second side 45 can extend farther from the inner surface 42 than the first side 44.

  The first side 44 may include a mating feature 46 at the first end 30, at least one mating feature 47 at the middle portion, and a mating feature 48 at the second end 32.

  The mating feature 46 may be substantially C-shaped, V-shaped, U-shaped, or other suitable shape. In the illustrated embodiment, the mating feature 46 forms a slidable joint with a corresponding mating feature (eg, one of the mating features 77 or 146 described in further detail below). Can do. The slidable joint may be, for example, a table-like splice joint or another suitable joint. That is, the mating feature 46 and its corresponding mating feature 77 or 146 may be similarly shaped to have a groove disposed between the two shoulders. One shoulder of the mating feature 46 can slide within the groove of the corresponding mating feature 77 or 146, while one shoulder of the corresponding mating feature 77 or 146 is It can slide in the groove of the fitting feature 46. It should be understood that in some embodiments, the mating feature 46 and its corresponding mating feature 77 or 146 may be formed in any other suitable manner. For example, the mating feature 46 and its corresponding mating feature 77 or 146 may form another splice joint, tongue and groove joint, another suitable joint, or another suitable one another. May be related in various ways. In some embodiments, the mating feature 46 and its corresponding mating feature 77 or 146 may be slidable and / or coupled to each other. In some embodiments, the mating feature 46 is inclined along the longitudinal axis 200 from the first end 30 of the end plate 14, 16 toward the middle portion of the end plate 14, 16. Also good.

  In the embodiment shown in FIGS. 11 and 12, the mating feature 47 is shown as defining an inwardly facing recess or groove. The recesses in the mating features 47 can receive the protrusions or tongues of the corresponding mating features (eg, mating features 84 and 86 described in further detail below). Thus, the mating feature 47 and its corresponding mating feature 84 or 86 can form a tongue and groove joint. That is, the tongue of the corresponding fitting feature 84 or 86 may be slidable within the groove of the fitting feature 47. The mating feature 47 and its corresponding mating feature 84 or 86 may form another type of joint, such as, for example, a splice joint, another suitable joint, or another suitable joint. May be related in various ways. In some embodiments, the mating features 47 and their corresponding mating features 84 or 86 may be slidably coupled to one another. In some embodiments, the mating feature 47 is inclined along the longitudinal axis 200 from a respective intermediate portion of the end plates 14, 16 toward the first end 30 of the end plates 14, 16. It may be. Thus, the inclined surfaces of the fitting feature 46 and the fitting feature 47 can be substantially opposite each other. Alternatively, the mating feature 47 is inclined in any other suitable direction, for example, from a respective intermediate portion of the end plates 14,16 toward the second end 32 of the end plates 14,16. May be.

  The mating feature 48 and its corresponding mating feature (eg, mating features 78 and 148 described in further detail below) may be substantially similar to mating feature 46 described above. . In some embodiments, the mating feature 48 is inclined along the longitudinal axis 200 from the second end 32 of the end plate 14, 16 toward the middle portion of the end plate 14, 16. Also good. Thus, the inclined surfaces of the mating features 46 and 48 may be opposed to each other, but the inclined surfaces of the mating features 47 and 48 may be substantially aligned (eg, substantially parallel).

  The second side 45 may include a fitting feature 49 at the first end 30, at least one fitting feature 50 at the middle portion, and a fitting feature 51 at the second end 32. The fitting feature 49 is similar to the fitting feature 46 described above, except that the fitting feature 49 can have a different (eg, larger) dimension than the fitting feature 46. Also good. Similar to the mating feature 46, the mating feature 49 is inclined along the longitudinal axis 200 from the first end 30 of the end plates 14, 16 toward the middle portion of the end plates 14, 16. It may be.

  The mating feature 50 may be similar to the mating feature 47, except that the mating feature 50 may have a different (eg, larger) dimension than the mating feature 47. . Similar to the mating feature 47, the mating feature 50 extends from the respective intermediate portions of the end plates 14, 16 along the longitudinal axis 200 toward the first end 30 of the end plates 14, 16. It may be inclined. Thus, the inclined surfaces of the fitting feature 49 and the fitting feature 50 can be substantially opposite each other. Alternatively, the mating feature 50 is inclined in any other suitable direction, for example, from a respective intermediate portion of the end plates 14, 16 toward the second end 32 of the end plates 14, 16. May be.

  The fitting feature 51 may be substantially similar to the fitting feature 46 described above. However, in some embodiments, the mating feature 51 can have a different (eg, larger) dimension than the mating feature 46. Similar to the mating feature 46, the mating feature 51 extends along the longitudinal axis 200 (see FIG. 10) from the second end 32 of the end plates 14, 16 to the middle of the end plates 14, 16. It may be inclined toward the part. Thus, the inclined surfaces of the mating features 46 and 48 can oppose each other, but the inclined surfaces of the mating features 50 and 51 can be substantially aligned (eg, substantially parallel).

  The mating features 46-51 may be configured to mate in a slidable and / or connected relationship with a corresponding mating feature of one of the first and second lamps 18 and 20. Good.

  The outer surface 40 and / or the inner surface 42 may be curved about one or more axes. For example, the outer surface 40 and / or the inner surface 42 may be curved about the longitudinal axis 200. Thus, in one embodiment, the outer surface 40 may be convex while the inner surface 42 may be concave about the longitudinal axis 200. In some embodiments, material can be added or removed from the outer surface 40 to modify the interaction between the outer surface 40 and the vertebral bodies 2 and 3. For example, material can be added to give the outer surface a substantially flat configuration while maintaining the concave surface of the inner surface 42.

  Each mating feature of the end plates 14, 16 may be curved to impart curvature to the first and second sides 22, 24 of the expandable fixation device 10 assembled as described above. . As best seen in FIG. 13, the first and second sides 44 and 45 may be curved about the center of rotation P (eg, may have a radius of curvature), and thus The mating features 46-51 disposed on one of the first and second sides 44, 45 can be similarly curved with respect to the rolling center P.

  In some embodiments, the outer surface 40 of the end plates 14, 16 is flat and substantially flat so that the outer surface 40 can engage an adjacent vertebral body. Alternatively, the outer surface 40 can be convexly or concavely curved to increase or decrease the degree of engagement with adjacent vertebral bodies. It is also contemplated that the outer surface 40 is substantially flat, but may include a substantially straight ramped surface or a curved ramped surface. The ramp-like surface can allow engagement with adjacent vertebral bodies in a further lordotic manner. In one embodiment, the outer surface 40 may include a texture that assists in gripping adjacent vertebral bodies. Although not limited to the following, the texture may include teeth, ridges, friction increasing elements, keels, or gripping or purchasing protrusions.

  Referring now to FIGS. 11, 12 and 16, the first lamp 18 connects the first end 70, the second end 72, the first end 70 and the second end 72. There may be a first side 74 and a second side 76 opposite the first lamp 18 connecting the first end 70 and the second end 72. The first ramp 18 is adapted to receive a third end (eg, upper end) 28 sized to receive at least a portion of the first end plate 14 and at least a portion of the second end plate 16. A fourth end (eg, lower end) 29 of size may further be included.

  The first end 70 of the first ramp 18 may include four mating features 77, 78, 80 and 82 (the mating feature 82 shown only in FIG. 16) in the exemplary embodiment. Good. Each of the mating features 77, 78, 80, 82 may be shaped to mate with a respective mating feature disposed on one of the end plates 14, 16. The fitting feature 77 may be configured to mate with the fitting feature 46 of the end plate 14 and may be molded similarly. The mating feature 78 may be configured to mate with the mating feature 48 of the end plate 16 and may be molded similarly. The fitting feature 80 may be configured to fit with the fitting feature 49 of the end plate 14 and may be molded similarly. The fitting feature 82 may be configured to mate with the fitting feature 51 of the end plate 16 and may be molded similarly. Each of the mating features 77, 78, 80 and 82 has a substantially inclined surface (relative to the assembled expandable fixation device 10) substantially with the respective mating feature described above. Can do. In one embodiment, each of the mating features 77, 78, 80, and 82 is inclined from an intermediate portion of the first ramp 18 toward the first end 70 of the first ramp 18, Other suitable configurations are also contemplated. In one embodiment, mating features 77 and 78 extend from third end 28, while mating features 78 and 82 extend from fourth end 29.

The first side 74 may include a mating feature 84 configured to mate with various mating features of the end plates 14, 16.

The fitting feature 84 may be a protrusion that extends from an intermediate portion of the first side 74 toward the first end 70. In one embodiment, the mating feature 84 can have a surface that slopes from an intermediate portion of the first side 74 toward the first end 70. The inclined surface of the fitting feature 84 can also extend laterally outward from the first side 74. The mating feature 84 can also extend from the third end 28 of the first lamp 18. The inclined surface of the mating feature 84 may extend toward a substantially flat surface that is substantially parallel to the longitudinal axis 200 of the expandable fixation device 10. In one embodiment, the first ramp 18 may include at least two mating features 84 that are zigzag along the first side 74, although other suitable numbers of mating features 84. May alternatively be used. In the illustrated embodiment, the mating features 84 are substantially similar to one another, but the mating features 84 may be different from one another. The fitting feature 84 may be configured to mate with the fitting feature 47 of the end plate 14. In the embodiment shown in FIGS. 11 and 12, the mating features 47 and 84 are slidable connections (eg, tongues and grooves) that move the expandable fixation device 10 between the collapsed and expanded configurations. A junction can be formed. However, it is contemplated that the mating features 47 and 84 may be modified to other suitable configurations that move the expandable fixation device 10 between a collapsed configuration and an expanded configuration. For example, in one alternative embodiment, the fitting feature 47 may be formed as a protrusion, while the fitting feature 84 is formed as a recess. In another alternative embodiment, each of the mating features 47 and 84 may be formed as a groove disposed between two shoulders so that the mating features 47 and 84 are spliced. A joint portion (for example, the same as the above table-like splice joint portion) is formed.

The fitting feature 86 may be a protrusion that extends from an intermediate portion of the first side 74 toward the first end 70. In one embodiment, the mating feature 86 can have a surface that slopes from an intermediate portion of the first side 74 toward the first end 70. The inclined surface of the fitting feature 86 can also extend laterally outward from the first side 74. Unlike the mating feature 84, the mating feature 86 can extend from the fourth end 29 of the first lamp 18. Thus, the mating features 84 and 86 can extend from the first side 74 in a generally opposite vertical direction. The inclined surface of the mating feature 86 may extend toward a substantially flat surface that is substantially parallel to the longitudinal axis 200 of the expandable fixation device 10. In one embodiment, the first ramp 18 can include at least two mating features 86 that are zigzag along the first side 74, although other suitable numbers of mating features. 86 may alternatively be used. In some embodiments, each of the mating features 84 and 86 may be zigzag to each other, although other suitable configurations are contemplated. In the illustrated embodiment, the mating features 86 are substantially similar to one another, but the mating features 86 may be different from one another. The fitting feature 86 may be configured to mate with the fitting feature 47 of the end plate 16. In the embodiment shown in FIGS. 11 and 12, the mating features 47 and 86 are slidable connections (eg, tongues and grooves) that move the expandable fixation device 10 between the folded and expanded configurations. A junction can be formed. However, the mating features 47 and 86 may cause the expandable fixation device 10 to move between a collapsed configuration and an expanded configuration (eg, substantially similar methods as described above for mating features 47 and 84). It is contemplated that other suitable configurations for movement may be modified.

Second side 76 may include mating features 88 and 90 that are configured to mate with various mating features of end plates 14, 16.

The fitting feature 88 may be a protrusion that extends from an intermediate portion of the second side 76 toward the first end 70. In one embodiment, the mating feature 88 can have a surface that slopes from an intermediate portion of the second side 76 toward the first end 70. The inclined surface of the fitting feature 88 can also extend laterally outward from the second side 76. The mating feature 88 can also extend from the third end 28 of the first lamp 18. The inclined surface of the mating feature 88 may extend toward a substantially flat surface that is substantially parallel to the longitudinal axis 200 of the expandable fixation device 10. In one embodiment, the first ramp 18 may include at least two mating features 88 that are zigzag along the second side 76, although other suitable numbers of mating features 88. May alternatively be used. In the illustrated embodiment, the mating features 88 are substantially similar to one another, but the mating features 88 may be different from one another. The fitting feature 88 may be configured to mate with the fitting feature 50 of the end plate 14. In the embodiment shown in FIGS. 11 and 12, the mating features 50 and 88 are slidable connections (eg, tongues and grooves) that move the expandable fixation device 10 between a collapsed configuration and an expanded configuration. A junction can be formed. However, the mating features 50 and 88 allow the expandable fixation device 10 to be moved between a collapsed configuration and an expanded configuration (eg, substantially similar methods as described above for mating features 47 and 84). It is contemplated that other suitable configurations for movement may be modified.

The fitting feature 90 may be a protrusion that extends from an intermediate portion of the second side 76 toward the first end 70. In one embodiment, the mating feature 90 can have a surface that slopes from an intermediate portion of the second side 76 toward the first end 70. The inclined surface of the fitting feature 90 can also extend laterally outward from the second side 76. Unlike the mating feature 88, the mating feature 90 can extend from the fourth end 29 of the first lamp 18. Thus, the mating features 88 and 90 can extend from the second side 76 in a generally opposite vertical direction. The inclined surface of the mating feature 90 may extend toward a substantially flat surface that is substantially parallel to the longitudinal axis 200 of the expandable fixation device 10. In one embodiment, the first ramp 18 may include at least two mating features 90 that are zigzag along the second side 76, although other suitable numbers of mating features 90. May alternatively be used. In some embodiments, each of the mating features 88 and 90 may be zigzag to each other, although other suitable configurations are contemplated. In the illustrated embodiment, the mating features 90 are substantially similar to one another, but the mating features 90 may be different from one another. The fitting feature 90 may be configured to fit with the fitting feature 50 of the end plate 16. In the embodiment shown in FIGS. 11 and 12, the mating features 50 and 90 are slidable connections (eg, tongues and grooves) that move the expandable fixation device 10 between a collapsed configuration and an expanded configuration. A junction can be formed. However, the mating features 50 and 90 allow the expandable fixation device 10 to be moved between a collapsed configuration and an expanded configuration (eg, substantially similar methods as described above for mating features 47 and 84). It is contemplated that other suitable configurations for movement may be modified.

Each mating feature of the first lamp 18 may be curved to impart curvature to the first and second sides 22, 24 of the assembled expandable fixation device 10 as described above. . In other words, the fitting feature of the first lamp 18 can have a radius of curvature centered on the rolling center P. Further, since the mating features of the first ramp 18 may be complementary to the corresponding mating features along the end plates 14, 16, the mating features of the end plates 14, 16 It can also have a radius of curvature centered on P. With reference to FIG. 17, the fitting features 77, 78, 80, 82, 84, 86, 88, and 90 can each have a radius of curvature about the inversion center P. Thus, all or part of the first ramp 18 can be bent about the center of rotation P. The shape of the first lamp 18 (eg, any of the aforementioned radii of curvature) may be approximated with simpler features to facilitate manufacturing.

As shown in FIG. 11, the first lamp 18 can include both a bore 418 and a bore 515. In some embodiments, the bore 418 is screwable and may be configured to receive the screw member 302 of the actuation mechanism 300. The central longitudinal axis of the bore 418 may be offset from the central longitudinal axis of the first lamp 18 to accommodate the bore 515.

The adjacent bore 515 functions as an access port, and if desired, implant material can be delivered through the first ramp 18 either prior to insertion or even in situ. As described below, the bore 418 can be aligned with a bore 366 in the second ramp 20 and the bore 515 can be aligned with an additional bore 512 in the second ramp 20.

The second lamp 20 may be disposed adjacent to the first lamp 18 in the expandable fixation device 10. The second ramp 20 can include four mating features 146, 148, 149 and 151. Each of the mating features 146, 148, 149 and 151 may be substantially similar to the mating feature 46 described above, with each mating feature disposed on one of the end plates 14,16. You may be comprised so that a part may be fitted. The fitting feature 146 may be configured to fit with the fitting feature 46 of the end plate 16. The fitting feature 148 may be configured to mate with the fitting feature 48 of the end plate 14. The fitting feature 149 may be configured to fit with the fitting feature 49 of the end plate 16. The fitting feature 151 may be configured to fit with the fitting feature 51 of the end plate 14.

Each mating feature of the second lamp 20 may be curved to impart curvature to the first and second sides 22, 24 of the assembled expandable fixation device 10 as described above. . Furthermore, the fitting feature of the second ramp 20 may have a radius of curvature about the center of rotation P, and the fitting feature of the end plates 14, 16 also has a curvature about the center of rotation P. It may have a radius. The fitting features 146, 148, 149 and 151 may all be curved about the center of rotation P. Therefore, all or part of the second lamp 20 can be bent around the center of rotation P. The shape of the second lamp 20 (eg, any of the aforementioned radii of curvature) may be approximated with simpler features to facilitate manufacturing.

In one alternative embodiment, the expandable fixation device 10 may be formed to position the centroid P within the lateral width of the expandable fixation device 10 along the first side 22 of the expandable fixation device 10. . In this alternative embodiment, all fits disposed along the first side 22 of the expandable fixation device 10 (eg, along the end plates 14, 16 and the first and second ramps 18 and 20). Combined features (eg, tracks, protrusions, grooves, shoulders, etc.) may be replaced by interlocking or pivoting mechanisms. When the inversion P is positioned within the lateral width of the expandable fixation device 10 along the first side 22 of the expandable fixation device 10, only the second side 24 is during expansion and folding of the expandable fixation device 10. , It can rotate around the center of rotation P.

As described above, the second lamp 20 can include a bore 366 adjacent to the bore 512. The bore 366 may be configured to receive the actuation mechanism 300 therethrough and may be aligned with the bore 418 in the first ramp 18. Accordingly, the bore 366 can have a central longitudinal axis that is offset from the central longitudinal axis of the second lamp 20 to accommodate adjacent bores 512. The bore 512 of the second ramp 20 may be aligned with the bore 515 of the first ramp 18 so that the implant material is inserted into the implant either before or even after insertion of the implant. .

The first and second ramps 18 and 20 may be wedges having inclined surfaces that each extend in at least two planes. That is, each of the first and second ramps 18 and 20 may be a wedge having an inclined surface extending along a plane defined by the longitudinal axis 200 (ie, inclined along the longitudinal axis 200). May be a wedge having an inclined surface that extends along a plane defined by the transverse axis 202 (ie, may be inclined along the transverse axis 202). The slopes of the first and second ramps 18 and 20 (and their associated mating features) along the longitudinal axis 200 of the expandable fixation device 10 are such that the first and second ramps 18 and 20 are When translating relative to each other along the longitudinal axis 200, the end plates 14 and 16 can be allowed to expand / compress. The inclined surfaces of the first and second ramps 18 and 20 along the transverse axis 202 of the expandable fixation device 10 are irregular lengths on the first and second sides 44 and 45 of the end plates 14 and 16. Can respond.

A method of installing the expandable fixation device 10 of FIG. 1 is now considered according to one embodiment of the present disclosure. Prior to insertion of the expandable fixation device 10, the intervertebral space may be prepared. In one installation method, a discectomy may be performed and the entire disc can be removed. Alternatively, only a portion of the disc may be removed. Next, the end plates of adjacent vertebral bodies 2, 3 can be scraped to create an exposed end surface to promote bone growth throughout the intervertebral space. One or more introducer sheaths can then be inserted into the disc space. The expandable fixation device 10 can then be introduced into the intervertebral space below the insertion sheath and placed in place within the disc space.

After the expandable fixation device 10 has been inserted into the proper location within the disc space, the expandable fixation device 10 can then transition from the collapsed configuration to the expanded configuration. To expand the expandable fixation device 10, the second lamp 20 may be moved toward the first lamp 18. As the first and second ramps 18 and 20 move toward each other, the respective mating features of the first and second ramps 18 and 20 are correspondingly disposed on the end plates 14 and 16. By pressing against the mating feature, the expandable fixation device 10 can be moved to the expanded configuration. In some embodiments, one or more of the end plates 14, 16 and the first and second lamps 18, 20 include a locking feature for securing the expandable fixation device 10 in an expanded configuration. But you can.

In the event that the expandable fixation device 10 needs to be repositioned or modified after installation and expansion, when the expandable fixation device 10 is deflated back into the folded configuration and repositioned to achieve the desired positioning Can be expanded again. To contract the expandable fixation device 10, the first lamp 18 is moved away from the second lamp 20 via the actuation mechanism 300.

Actuating mechanism 300 may include any suitable actuating mechanism configured to translate first and second ramps 18 and 20 toward and away from each other along longitudinal axis 200. 4 and 7, the actuation mechanism 300, when rotated in the first direction, guides the first and second ramps 18 and 20 toward each other and moves the expandable fixation device 10 from the collapsed configuration to the expanded configuration. A screw member 302 (e.g., a screw) may be included. When the screw member 202 rotates in a second direction opposite to the first direction, the first and second ramps 18 and 20 can move away from each other and fold the expandable fixation device 10. Return to configuration. In one embodiment, the screw member 302 may be partially disposed through the bore 515 of the first ramp 18 and through the bore 515 as the expandable fixation device 10 moves from the collapsed configuration to the expanded configuration. It can extend further. In this embodiment, the screw member 302 can push the second ramp 20 toward the first ramp 18 and the expandable fixation device 10 transitions from the collapsed configuration to the expanded configuration and collapses from the expanded configuration. During the transition to the configuration, it can move with the same spread as the second lamp 20.

In the alternative embodiment shown in FIG. 19, the screw member 302 may be at least partially disposed within the bore 515 in a folded configuration. However, the screw member 302 may be actuated through the second ramp 20 to transition from the collapsed configuration to the expanded configuration. Unlike the embodiment shown in FIGS. 4 and 7, in the embodiment of FIG. 19, the screw member 302 can push the first ramp 18 toward the second ramp 20 and During the transition from the folded configuration to the expanded configuration, and from the expanded configuration to the folded configuration, it can move with the same extent as the first ramp 18. Any other suitable actuation mechanism may utilize, for example, a slider, pusher, ratchet, or the like.

In some embodiments, the screw member 302 can be directly rotated to actuate the actuation mechanism 300. In some embodiments, the inserter (not shown) may be configured to be screwed into the screw member 302 or otherwise coupled thereto. In such an embodiment, the inserter is actuated by a suitable mechanism (eg, a tool, ratchet, or the like) to rotate the screw member 302 so that the first and second ramps 18 and 20 are relative to each other. The position can be adjusted.

In some embodiments, only one of the bores 366 and 418 may be screwed so that the expandable fixation device 10 can be actuated by linear movement of the actuation mechanism 300. For example, in one embodiment, the bore 366 may be screwable, but the bore 418 may not be screwable. In such embodiments, the screw member 302 may be screwed into the bore 366 and slidable through the bore 418. After the screw member 302 is screwed through the bore 366, the screw member 302 can be selectively pushed through the bore 418 to move the expandable fixation device 10 from the collapsed configuration to the expanded configuration (eg, a first By bringing the lamp 18 and the second lamp 20 close together). Additionally, the screw member 302 can be pulled in the opposite direction to move the expandable fixation device 10 from the folded configuration to the expanded configuration (eg, separating the first ramp 18 and the second ramp 20 from each other). By). In this embodiment, the second ramp 20 can be pushed toward the first ramp 18 to move the expandable fixation device 10 from the collapsed configuration to the expanded configuration.

In alternative embodiments, the bore 418 may be threaded and the bore 366 may not be threaded. In such an embodiment, screw member 302 may be disposed through bore 366 and screwed into bore 418 (see, eg, FIG. 19). The screw member 302 can be pulled linearly to move the expandable fixation device 10 from the folded configuration to the expanded configuration (eg, by bringing the first ramp 18 and the second ramp 20 closer together). Additionally, the screw member 302 can be pushed to return the expandable fixation device 10 from the expanded configuration to the folded configuration (eg, by moving the first ramp 18 and the second ramp 20 away from each other). In this embodiment, the first ramp 18 can be pulled toward the second ramp 20 to move the expandable fixation device 10 from the collapsed configuration to the expanded configuration.

In one embodiment, the locking member (eg, a screw not shown) may be separately disposed on the expandable fixation device 10 during the transition between the collapsed configuration and the expanded configuration. Once the final position is achieved (eg, the expanded configuration of the expandable fixation device 10), the locking member can be advanced to lock the expandable fixation device 10 in the desired configuration. In some embodiments, the locking member may be integral with the expandable fixation device 10 or alternatively may be introduced after expansion. In some embodiments, the locking member may be captured within the expandable fixation device 10 so that it is not lost. In some embodiments, peening the tip of the locking member can prevent loss of the locking member.

When the expandable fixation device 10 is moved to the expanded configuration and locked by the locking member, utilizing the bores 366 and 418 previously used to expand the expandable fixation device 10 by the locking member, actuation mechanism 300. The expandable fixation device 10 can be filled with a graft or other bone growth inducer. That is, the bores 366 and 418 can be used to fill the expandable fixation device 10 with the implant to fill any potential gap formed during expansion of the expandable fixation device 10.

  With reference to FIGS. 20-24, an embodiment of an expandable fixation device 100 is shown. In the exemplary embodiment, expandable fixation device 100 can include a first end plate 114, a second end plate 116, a first ramp 118, and a second ramp 120. The first and / or second endplates 114, 116 of the expandable fixation device 100 can include one or more openings 126 to accommodate bone growth and / or bone growth material.

  The first end plate 114 has an outer surface 140 configured to engage adjacent vertebral bodies and an inner surface 142 configured to mate with at least a portion of the first and second ramps 118, 120. Including. The second end plate 116 has an outer surface 145 configured to engage adjacent vertebral bodies and an inner surface 144 configured to mate with at least a portion of the first and second ramps 118, 120. Including. The first ramp 118 includes an upper portion 128 sized to receive at least a portion of the first end plate 114 and a lower portion 129 sized to receive at least a portion of the second end plate 116. The second lamp 120 may be disposed adjacent to the first lamp 118. The second lamp 120 includes an upper portion 122 sized to contact at least a portion of the first end plate 114 and a lower portion 124 sized to contact at least a portion of the second end plate 116. The first and / or second lamps 118, 120 can include any of the mating features described herein.

  The first lamp 118 can include one or more bores 162, 164. The second lamp 120 can include a bore 166 adjacent to the bore 168. The bore 166 may be configured to receive the actuation mechanism 300 therethrough and may be aligned with the bore 164 in the first ramp 118. The bores 164, 166 may be screwed so that the expandable fixation device 100 can be actuated by linear movement of the actuation mechanism 300. The actuation mechanism 300 can include the screw member 302 as described above. The actuation mechanism can also include one or more retaining rings 134 and / or washers 136. Retaining ring 134 and washer 136 may be formed from any suitable material such as titanium, PEEK, or the like. After the screw member 302 is screwed through the bore 166, the screw member 302 can be selectively screwed through the bore 164 to move the expandable fixation device 100 from the collapsed configuration to the expanded configuration (eg, a first By bringing the lamp 118 and the second lamp 120 close together).

  Accordingly, the expandable fixation device 100 can be movable between a collapsed configuration and an expanded configuration, as described herein. After the expandable fixation device 100 has been inserted into the proper location within the disc space, the expandable fixation device 100 can then transition from the collapsed configuration to the expanded configuration. To expand the expandable fixation device 100, the second lamp 120 may be moved toward the first lamp 118. As the first and second ramps 118 and 120 move toward each other, the respective mating features of the first and second ramps 118 and 120 are correspondingly disposed on the end plates 114 and 116, respectively. By pressing against the mating feature, the expandable fixation device 100 can be moved to the expanded configuration. Thus, the expandable fixation device 100 can move relative to each other between the collapsed configuration and the expanded configuration.

  Depending on the desired expansion profile, a symmetric or asymmetric expansion of the device 100 may be required. However, even if symmetric expansion is preferred, an expandable implant that utilizes a ramp for expansion may be subject to an indefinite expansion rate. For example, depending on the slope of the ramp interface or the shape of the mating feature, the end plates 114, 116 may expand at a faster rate at the back of the implant, as opposed to the front of the implant. This is illustrated, for example, in FIG. 22 where the arrows indicate relative expansion rates. By making the front ramp angle different from the rear angle, the asymmetric expansion problem can be reduced. For example, increasing the front ramp angle and decreasing the rear ramp angle ensures that the end plates 114, 116 expand symmetrically.

  The front and rear ramp angles may be the same or different. As shown in FIGS. 23 and 24, the angle ε is provided to the front ramp angle (eg, the angle (s) on the mating feature of the first ramp 118) and the angle δ is set to the rear ramp angle (eg, , The angle (s) on the mating feature of the second ramp 120). These angles ε, δ are measured from the vertical axis μ. An angle ε may be provided on the mating surface for the first ramp 118, the first end plate 114, and / or the second end plate 116, respectively. An angle δ may be provided on the mating surface for the second ramp 120, the first end plate 114, and / or the second end plate 116, respectively. The angle ε is preferably greater than the angle δ, for example at a ratio of about 4: 1. The angle ε can range from about 50-70 °, 55-65 °, 57-63 °, 58-62 °, or 59-61 °. In a preferred embodiment, the angle ε is 60 °. The angle δ can range from about 5-25 °, 10-20 °, 12-18 °, 13-17 °, 14-16 °. In a preferred embodiment, the angle δ is 15 °. Increasing the angle ε and decreasing the angle δ in this manner ensures that the end plates 114, 116 expand symmetrically. By expanding symmetrically, the end plates 114, 116 can properly contact the vertebral body end plates and maintain an anatomical balance in situ. Although symmetric expansion is described, asymmetric expansion can also be contemplated. The angles ε, δ may be changed or adjusted to provide asymmetric expansion of the end plates 114, 116.

  With reference to FIGS. 25 and 26, an embodiment of a first front ramp 218 suitable for use with any of the expandable fixation devices described herein is shown. The first ramp 218 includes a first end 270 on the insertion end of the device, a second end 272 configured to mate with the second ramp 20, 120, a first side 274. , And a second side 276 opposite the first lamp 218. The first ramp 218 can generally extend from the first side 222 (eg, the back side) to the second side 224 (eg, the front side). The first ramp 218 may be generally wedge shaped and may have a height that increases from the first side 222 toward the second side 224. The first ramp 218 includes an upper portion 228 sized to receive at least a portion of the first end plate 14, 114 and a lower portion sized to receive at least a portion of the second end plate 16, 116. 229 may further be included. As described above, the second end 272 of the first ramp 218 can include bores 418, 515. In some embodiments, the bore 418 may be configured to receive the screw member 302 of the actuation mechanism 300. The adjacent bore 515 functions as an access port and can deliver the implant material through the first ramp 218 prior to insertion or in situ.

  The first ramp 218 may have a curvature or pitch on at least one ramp surface or mating feature. For example, the first end 270 may have a curved ramp surface 271. The second side or front side 224 may have a higher ramp angle than the first side or back side 222, or vice versa. One or more portions of the first ramp 218 that include one or more of the ramp surfaces or mating features may include a continuously varying ramp angle. A continuous linear change in the angle of the implant (eg, the lordosis angle) can be associated with a continuously changing ramp angle. This results in a curvature of the lamp surface that can be defined by an angular change per distance away from the axis of rotation π. This value is the pitch of the embedded lamp surface and is responsible for changing the rate of angular change that the embedded piece can achieve. A larger pitch value is associated with a higher lamp angle at the front lamp end with respect to the angle at the rear lamp end for a fixed width implant. Mating feature, ramp angle, type of angle change, forward angle, expansion rate, and the like are configured to provide optimal design and functionality of the device as described herein Can be done.

Any aspect described in any embodiment may be used with any other embodiment described herein. Any of the devices and apparatus described herein may be used in any suitable medical procedure, such as a disc replacement procedure, and can be advanced through any suitable body lumen and body cavity.

It will be apparent to those skilled in the art that various modifications and variations can be made in the disclosed system and process without departing from the scope of the disclosure. Other embodiments of the disclosure will be apparent to those skilled in the art from consideration of the specification and practice of the disclosure disclosed herein. It is intended that the specification and examples be considered as exemplary only. The following disclosure identifies several other exemplary embodiments.

Claims (14)

An expandable fixation device,
A first end plate having an outer surface extending from first and second side ends and a second end plate having an outer surface extending from first and second side ends , each having at least one mating feature A first end plate and a second end plate including a portion;
A first ramp configured to mate with both the first and second end plates, wherein the first ramp has a first angle with respect to a vertical axis. And wherein the at least one mating feature of the first end plate or the second end plate slides relative to a corresponding first mating feature disposed on the first ramp. A first lamp that is movable;
The first side has a front side, a rear side, and first and second side sides, the front side faces the insertion direction of implantation, and the rear side does not face the insertion direction of implantation . And a second ramp configured to mate with both the second end plate and including a mating feature having a second angle with respect to the vertical axis; With
Said first angle, Unlike the second angle,
The rear side of the second lamp defines a back surface;
The back surface of the second lamp includes a plurality of boreholes;
The height of the second side of the second lamp is different from the height of the second side of the second lamp,
The expandable fixation device is moveable between a folded configuration and an expanded configuration, wherein the first end plate is moved from the first side end to the second side end in the folded configuration. The outer surface forms a first end plate angle with respect to the outer surface of the second end plate from the first side end to the second side end;
Said first end plate angle, Ru inclination der scalability fixation device.   The expandable fixation device of claim 1, wherein the first angle is greater than the second angle. The first angle is a 5 0 to 70 °, scalability fixation device according to claim 1. The expandable fixation device of claim 1, wherein the first angle is 60 °. The expandable fixation device of claim 1, wherein the second angle is 5 to 25 degrees. The second angle is at 1 5 °, scalability fixation device according to claim 1.   The expandable fixation device of claim 1, wherein the first and second lamps are configured to provide a symmetrical expansion of the first and second end plates.   The expandable fixation device of claim 1, wherein at least a portion of the first lamp includes a curved lamp surface.   The expandable fixation device of claim 1, wherein at least a portion of the first ramp has a continuously varying ramp angle.   Each of the first and second end plates has an inner surface configured to mate with the first lamp, and the inner surfaces of each of the first and second end plates are concave curved surfaces. The expandable fixation device of claim 1, wherein the concave curved surface is formed about a longitudinal axis of the expandable fixation device.   The expandable fixation device of claim 1, wherein the expandable fixation device is movable between a folded configuration and an expanded configuration.   The first ramp is coupled to the second ramp by an actuation mechanism, and the expandable fixation device transitions from the folded configuration to the expanded configuration by actuation of the actuation mechanism, so that the second ramp And the expandable fixation device of claim 11, wherein the expandable fixation device is configured to move the first lamp toward each other.   12. The expandable fixation device of claim 11, wherein in the expandable configuration, the expandable fixation device is a wedge having an inclined surface extending along a transverse axis of the expandable fixation device.   Each of the first and second end plates has an outer surface configured to contact a respective vertebral body, and each outer surface of the first and second end plates includes teeth, ridges, and increased friction The expandable fixation device of claim 1, having one or more of an element, keel, or gripping or purchasing protrusion.

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